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Ask Well: Feeding Heavy and Thin Kids Together

By Tara Parker-Pope June 16, 2014 4:54 pmJune 16, 2014 4:54 pm

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Credit Istock

Q

What is the best way to help a child lose weight?

What is the best way to help a child lose weight without upsetting the child, particularly when you have other children who are not overweight? I've curtailed serving sizes and cut back on treats for both of my kids. I encourage exercise and healthy eating -- and ironically the chubbier one eats a lot healthier than the skinny one. But a year later I still have one in the 90th percentile in weight and the other in the 25th percentile. I'm at a loss.

Asked by jd • 930 votes

A

This is a common issue for families, as biological siblings raised the same way can have different rates of development, food preferences and body types. The reader who asked the question noted that her overweight child eats healthfully but tends to be hungry more often and weighs in at the top of the B.M.I. charts. Meanwhile, a sibling likes junk food and never seems to gain weight.

“Oftentimes, seeing families like this, the parents let the thin kid have anything they want, including junk food, because they are happy to get her to eat,” said Dr. David Ludwig, the director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital. “They restrict the overweight kid. It sets up an unfair environment for the overweight kid and in some ways for the thin kid, too.”

So what’s the solution? The answer may surprise you. The food rules for both children should be the same.

Dr. Ludwig said the rules for healthful eating do not change because of a child’s weight. (The exception to this is a specific medical problem, like diabetes, gluten sensitivity or an eating disorder.)

In general, healthy children of all sizes should be encouraged to eat a variety of healthful foods. Processed foods and soft drinks should be kept out of the house. Both children should sit down to a regular family meal with a variety of healthful food options. Parents should be role models, eating a variety of fruits and vegetables, trying new foods and eating appropriate portions. Parents should refrain from arguing with children about food. Both children should be encouraged to stay active and get a good night’s sleep.

“It’s not that you can’t have occasional sweets or treats,” Dr. Ludwig said. “Take the overweight kid and the lean kid out for a treat once in a while, make it a celebration and don’t discriminate.

“Everybody should be treated exactly the same: no junk food, no opportunity to feel unfairly singled out and stigmatized.”

And if the overweight child wants to snack, it’s fine to give him or her access to healthful snack foods. If she asks for a second apple or extra helpings of vegetables and dip, let her have it.

“People don’t binge on apples for the most part because you fill up on them before a huge number of calories are consumed,” Dr. Ludwig said.

Of course, some food rules in the house are appropriate. They key is to apply them fairly to every member of the household, based on their age.

“It’s fair for parents to have guidelines around appropriate times to eat and times to stop,” Dr. Ludwig said.

“If a child is trying to avoid bedtime by saying, ‘Daddy, I’m hungry,’ it’s fine to say the kitchen is closed. But for adolescents, parents should control the quality of the foods and let the child determine how much they want to eat.”